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Community-based antibiotic access and use in six low-income and middle-income countries: a mixed-method approach

Do, Nga T. T. (författare)
Oxford University Clinical Research Unit, Hanoi, Viet Nam
Vu, Huong T. L. (författare)
Oxford University Clinical Research Unit, Hanoi, Viet Nam
Nguyen, Chuc T. K. (författare)
Department of Family Medicine, Hanoi Medical University, Hanoi, Viet Nam
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Punpuing, Sureeporn (författare)
Institute for Population and Social Research, Mahidol University, Nakhonpathom, Thailand
Khan, Wasif Ali (författare)
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
Gyapong, Margaret (författare)
Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
Asante, Kwaku Poku (författare)
Kintampo Health Research Centre, Kintampo, Ghana
Munguambe, Khatia (författare)
Manhiça Health Research Centre, Manhiça, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
Gómez-Olivé, F. Xavier (författare)
MRC–Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
John-Langba, Johannes (författare)
School of Applied Human Sciences, University of Kwazulu-Natal, Durban, South Africa
Tran, Toan K. (författare)
Department of Family Medicine, Hanoi Medical University, Hanoi, Viet Nam
Sunpuwan, Malee (författare)
Institute for Population and Social Research, Mahidol University, Nakhonpathom, Thailand
Sevene, Esperanca (författare)
Manhiça Health Research Centre, Manhiça, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
Nguyen, Hanh H. (författare)
Department of Family Medicine, Hanoi Medical University, Hanoi, Viet Nam
Ho, Phuc D. (författare)
Institute of Mathematics, Vietnam Academy of Science and Technology, Hanoi, Viet Nam
Matin, Mohammad Abdul (författare)
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
Ahmed, Sabeena (författare)
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
Karim, Mohammad Mahbubul (författare)
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
Cambaco, Olga (författare)
Manhiça Health Research Centre, Manhiça, Mozambique
Afari-Asiedu, Samuel (författare)
Kintampo Health Research Centre, Kintampo, Ghana
Boamah-Kaali, Ellen (författare)
Kintampo Health Research Centre, Kintampo, Ghana
Abdulai, Martha Ali (författare)
Kintampo Health Research Centre, Kintampo, Ghana
Williams, John (författare)
Dodowa Health Research Centre, Dodowa, Ghana
Asiamah, Sabina (författare)
Dodowa Health Research Centre, Dodowa, Ghana
Amankwah, Georgina (författare)
Dodowa Health Research Centre, Dodowa, Ghana
Agyekum, Mary Pomaa (författare)
Dodowa Health Research Centre, Dodowa, Ghana
Wagner, Fezile (författare)
MRC–Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
Ariana, Proochista (författare)
Nuffied Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
Sigauque, Betuel (författare)
Manhiça Health Research Centre, Manhiça, Mozambique
Tollman, Stephen (författare)
MRC–Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
van Doorn, H Rogier (författare)
Oxford University Clinical Research Unit, Hanoi, Viet Nam; Nuffied Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
Sankoh, Osman (författare)
School of Public Health, University of the Witwatersrand, Johannesburg, South Africa; Statistics Sierra Leone, Freetown, Sierra Leone; University Secretariat, Njala University, Njala, Sierra Leone; Heidelberg Institute for Global Health, University of Heidelberg Medical School, Heidelberg, Germany
Kinsman, John (författare)
Umeå universitet,Institutionen för epidemiologi och global hälsa
Wertheim, Heiman F L (författare)
Oxford University Clinical Research Unit, Hanoi, Viet Nam
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 (creator_code:org_t)
Elsevier, 2021
2021
Engelska.
Ingår i: The Lancet Global Health. - : Elsevier. - 2214-109X. ; 9:5, s. e610-e619
Relaterad länk:
https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
https://urn.kb.se/re...
https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Background: Antimicrobial misuse is common in low-income and middle-income countries (LMICs), and this practice is a driver of antibiotic resistance. We compared community-based antibiotic access and use practices across communities in LMICs to identify contextually specific targets for interventions to improve antibiotic use practices.Methods: We did quantitative and qualitative assessments of antibiotic access and use in six LMICs across Africa (Mozambique, Ghana, and South Africa) and Asia (Bangladesh, Vietnam, and Thailand) over a 2·5-year study period (July 1, 2016–Dec 31, 2018). We did quantitative assessments of community antibiotic access and use through supplier mapping, customer exit interviews, and household surveys. These quantitative assessments were triangulated with qualitative drug supplier and consumer interviews and discussions.Findings: Vietnam and Bangladesh had the largest proportions of non-licensed antibiotic dispensing points. For mild illness, drug stores were the most common point of contact when seeking antibiotics in most countries, except South Africa and Mozambique, where public facilities were most common. Self-medication with antibiotics was found to be widespread in Vietnam (55·2% of antibiotics dispensed without prescription), Bangladesh (45·7%), and Ghana (36·1%), but less so in Mozambique (8·0%), South Africa (1·2%), and Thailand (3·9%). Self-medication was considered to be less time consuming, cheaper, and overall, more convenient than accessing them through health-care facilities. Factors determining where treatment was sought often involved relevant policies, trust in the supplier and the drug, disease severity, and whether the antibiotic was intended for a child. Confusion regarding how to identify oral antibiotics was revealed in both Africa and Asia.Interpretation: Contextual complexities and differences between countries with different incomes, policy frameworks, and cultural norms were revealed. These contextual differences render a single strategy inadequate and instead necessitate context-tailored, integrated intervention packages to improve antibiotic use in LMICs as part of global efforts to combat antibiotic resistance.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)

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